Health equity in economic and trade policies

WTO Forum: Bypassing international agreements may hamper medicines access
Saez C: Intellectual Property Watch, 11 October 2009

Access to medicines in developing countries may be put at risk by European customs regulations and more broadly by trade provisions in most free trade agreements between developed and developing countries, said speakers at the recent World Trade Organization (WTO) Public Forum, held from 28–30 September. European Union (EU) regulation 1383/2003 concerning customs action against goods suspected of IP infringement is open to interpretation, said Sunjay Sudhir, counsellor at the Permanent Mission of India. There are fears that decisions taken under regulation 1383/2003 reflects a larger design for tougher enforcement of IP rights, part of which is a campaign of deliberately confusing quality concerns with IP rights in international organisations. The issue has arisen in the World Health Organization, and can be noticed in TRIPS-plus elements in bilateral free trade agreements, and the Anti-Counterfeiting Trade Agreement (ACTA) under negotiation to the exclusion of many countries, including developing and least-developed countries, according to Sudhir. ‘Regulation 1383/2003 should be reviewed and brought into line with TRIPS, GATT, and the Doha Declaration on the TRIPS agreement and public health,’ he recommended.

WTO General Council extends deadline for TRIPS health amendment
New W: Intellectual Property Watch, 1 December 2011

Paragraph 6 – the first and only amendment to the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) – allows Ministers to alter the TRIPS agreement so that developing countries can use compulsory licences to manufacture generic medicines exclusively for export to countries unable to make them themselves. Countries have not all ratified the amendment. On 30 November 2011, the World Trade Organisation (WTO) General Council agreed to extend the deadline for countries to adopt the amendment at national level from December 2011 to 31 December 2013. Two-thirds of the WTO membership (i.e. 102) must ratify the change for it to go into effect. By November 2011 only 39 countries had done so. There has been much discussion about whether the ‘Paragraph 6 solution’ has been effective, as after eight years it has only been used by Canada and Rwanda. Countries have raised that the process is too cumbersome.

WTO least-developed countries request waiver of IP rights on pharma products
Saez C, Intellectual Property Watch, 25 February 2015

In the World Trade Organization intellectual property committee meeting in February, least-developed countries (LDCs) submitted a request to extend a waiver allowing them not to enforce intellectual property rights on pharmaceutical products that goes to 2016. The countries have extended the waiver before, but this time they are seeking to make it indefinite, until they are no longer considered LDCs are disproportionately exposed to the health risks associated with poverty, and “patent protection contributes to high costs, placing many critical treatments outside the reach of LDCs, according to a communication by the group.

WTO members must commit to Doha, says MSF

MSF is concerned that further proliferation of so-called 'TRIPS plus' provisions in free trade agreeements negotiated by the United States may jeopardise the progress that has been made on access to medicines. This may have enormous consequences for the health and life of millions of people, says MSF, and this is particularly so given the deadline of 1st January 2005 after which pharmaceutical product patent protection has to be provided by all non-Least Developing Country Members. MSF says in a letter to EU Trade Commissioner Pascal Lamy that the adequate protection of public health demands that WTO Members be permitted to give full effect to the letter and spirit of the Doha Declaration on TRIPS and Public Health (“Doha Declaration”) in their domestic and/or regional legislation.

Further details: /newsletter/id/30349
WTO members to consider review of TRIPS public health amendment
Mara K: Intellectual Property Watch, 11 February 2010

A waiver to World Trade Organization (WTO) rules intended to aid people in poor countries in gaining access to medicines is reported to have remained essentially unused in the over six-and-a-half years since it was put in place. Member states of the WTO will be holding an informal meeting to discuss this situation and see what, if anything, needs be done. The 2003 waiver was made an amendment in 2005 within the WTO Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement to allow for increased export of medicines made under compulsory licences. This was intended to give a helping hand to nations without a domestic pharmaceutical industry, who might have public health needs for a patented and unaffordable medicine they are unable to produce themselves.
Under TRIPS, compulsory licences are meant to primarily serve a national market, but the TRIPS public health amendment (often referred to as the ‘paragraph 6’ solution referring to the Doha Declaration on TRIPS and Public Health) allows countries with pharmaceutical industries to manufacture and export more medicines under a compulsory licence to countries without them, provided certain conditions are met.

WTO’s least developed countries submit collective request on services waiver
Bridges Africa, 25 July 2014

In July the WTO’s poorest members, known as the Least Developed Country (LDC) Group, submitted a collective request regarding the preferential treatment they would like to see for their services and service suppliers. The move comes seven months after the global trade body’s ministerial conference in Bali, Indonesia, where members agreed to take steps for bringing this “services waiver” into operation. The LDC services waiver, as it is referred to in trade circles, was initially an outcome of the 2011 WTO Ministerial Conference, held in Geneva, Switzerland. However, in the two years that followed, no preferences had been requested by LDCs or granted to them, prompting WTO members to reconsider ways to use the services waiver. As a result, at the WTO’s subsequent ministerial conference in Bali, Indonesia last December, members agreed to initiate a process aimed at promoting the “expeditious and effective operationalisation” of the LDC services waiver. Over the next six months, WTO members will engage in consultations with the LDC Group in order to respond to the collective request at the high-level meeting. The LDCs have reserved the right to modify the request’s terms ahead of the event.

‘Big Food’: The consumer food environment, health, and the policy response in South Africa
Igumbor EU, Sanders D, Puoane TR, Tsolekile L, Schwarz C et al: PLoS Medicine 9(7), 3 July 2012

In South Africa, as elsewhere in the world, large commercial entities that dominate the food and beverage environment (‘Big Food’) are becoming more widespread and are implicated in unhealthy eating. Interestingly, the authors of this study found that small independent producers (‘Small Food’) remain significant in the food environment in South Africa, and are both linked with, and threatened by, Big Food. Big Food in South Africa involves South African companies, some of which have invested in other (mainly, but not only, African) nations, as well as companies headquartered in North America and Europe. These companies have developed strategies to increase the availability, affordability, and acceptability of their foods in South Africa, as well as having developed a range of ‘health and wellness’ initiatives. Whether these initiatives have had a net positive or net negative impact is not clear. The authors recommend that the South African government act urgently to mitigate the adverse health effects in the food environment in South Africa through education about the health risks of unhealthy diets and regulation of Big Food, including support for healthy foods.

‘Big Think’, disjointed incrementalism: Chinese economic success and policy lessons for Africa, or the case for pan-Africanism
Gros J: African Journal Of International Affairs 11(2): 55–87, 2008

Chinese economic success is not the product of free market accidental coincidence, according to this article – rather, it is orchestrated by the State through a mixture of nationalism (‘big think’) and pragmatic decisions (disjointed incrementalism) in agriculture, finance and industry. By following the Chinese example, the author argues for Pan-Africanism, a form of ‘big think’. The main obstacle to development in Africa, he argues, may well be how to align the vested, narrow interests of territorially bound rulers with their citizens, whose languages and cultures tend to transcend the colonially determined national boundaries and who are more likely to support development efforts if they are consonant with existing practices and values. The author argues that Pan-Africanism would allow Africa to take advantage of the economies of scale that accrue with larger markets, give Africa better leverage on its natural resources, allow for easier sharing of resources between rich and poor communities and give the continent greater international clout.

‘Big think’, disjointed incrementalism: Chinese economic success and policy lessons for Africa, or the case for Pan-Africanism
Gros J: African Journal of International Affairs 11(2): 55–87, 2008

Chinese economic success is not the product of free market accidental coincidence, according to this article – rather, it is orchestrated by the State through a mixture of nationalism (‘big think’) and pragmatic decisions (disjointed incrementalism) in agriculture, finance and industry. By following the Chinese example, the author argues for Pan-Africanism, a form of ‘big think’. The main obstacle to development in Africa, he argues, may well be how to align the vested, narrow interests of territorially bound rulers with their citizens, whose languages and cultures tend to transcend the colonially determined national boundaries and who are more likely to support development efforts if they are consonant with existing practices and values. The author argues that Pan-Africanism would allow Africa to take advantage of the economies of scale that accrue with larger markets, give Africa better leverage on its natural resources, allow for easier sharing of resources between rich and poor communities and give the continent greater international clout.

‘Free trade’ is not what Africa needs, Mr Cameron
Dearden N: The Guardian, Poverty Matters, 19 July 2011

On his trip to South Africa on 18 July 2011, British Prime Minister, David Cameron, talked of the need to go beyond debt cancellation and aid and instead promote free trade with Africa. But ‘free trade’ on inequitable terms has been and will be of no benefit to Africa, the author of this article argues. Africa has much to learn from South Korea, the model to which Cameron refers as a successful example of free-market liberalisation. What Cameron failed to point out, the author notes, is that South Korea used a range of government interventions that are not accepted in free trade practice and are being denied to African governments. The author argues that African prosperity relies on a wholesale rejection of the western free trade model, which means protecting industries, developing alternative and complementary means of trading, control of food production and banking, progressive tax structures, controlled use of savings, and strong regulation to ensure trade and investment really benefits people.

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